The Use of Buccal Fat Pad Versus Buccal Mucosal Flap in Cleft Patient Palatoplasty—A Literature Review

Abstract

The buccal fat pad and buccal mucosa are anatomical structures closely related to palatal clefts which can provide additional tissues for defect reconstruction which is crucial for practitioners aiming to lessen the need for additional corrective surgeries in patients with cleft palates and to lower the rates of residual palatal fistulae. Objectives: Aims to explore the recent scientific data available on the applications and outcomes of two surgical techniques involving the buccal fat pad and buccal mucosal flap in primary and secondary palatoplasty. Methods: The analyzed articles published between 2020 and 2025 from PubMed, Web of Science, and Scopus. The search strategy included terms related to buccal fat pad flaps, buccal mucosal flaps, and cleft palate repair. Results: After performing the search, including eligible articles and removing duplicates, 15 articles were included in this review. Eight studies explored the effectiveness of buccal fat pad or buccal mucosal flap during primary palatoplasty and seven studies for secondary palatoplasty. The articles included in this review provide insights on the usefulness of buccal fat pad flaps and buccal mucosal flaps in primary and secondary palatoplasty. Conclusions: The buccal fat pad and buccal mucosal flaps are highly effective in secondary palatoplasty, particularly for velopharyngeal dysfunction and fistula closure. In primary palatoplasty, the buccal fat pad flap aids mucosal healing, reduces complications, and improves speech, while the buccal mucosal flap is beneficial for wide palatal defects.